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Home My WebLink About34925-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA=qTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33956 Rte: 09/15/09 THIS c~KTIFIES that the building ELECTRICAL I~cation of Property: 1100 BAYER RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 107 Block 9 Subdivision Filed Map No. __ Lot No. -- MATTITUCK Lot 3O ( HAMLET ) conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 7, 2009 pursuant to which Building Permit No. 34925-Z dated AUGUST 12, 2009 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is "AS BUILT" ELECTRIC REWIRING IN KITCHEN OF AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to EVANGEL LUTH OF ADVENT CH. ( OWNER ) of the aforesaid building. SUFP~)IA~CO~DBP~/~T~T OF ~J~THAPPRO~-~J~ N/A E~.Rt-rKICAL c~TIFICATE NO. 4026570 07/23/09 pLiErS C~TIFICATION DA'£~D N/A uthorize Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of Water supply and sewerage-disposal (8.9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957} non-conforming uses, or buildings and "pre-existing" land uses: t Accurate survey of property showing all property Lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Oeeupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelluig $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00. Commercial $15.00 New Construction: Location of Property: House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. · Health Dept. Approval: Planning Board Approval: Old or Pre-existing Building: Street (check one) Date of Permit. Block Filed Map... Hamlet Lot ? -,03 Lot: Applicant: Underwriters Approval: .Request for: Temporary Certificate Final Certificate: /~ (check oneL Fee Submitted: $ ~,~ .er) 1100 BaysfRO '/ s Apl~cant Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~]ING PE~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34925 Z Date AUGUST 12, 2009 Permission is hereby granted to: LUTHER~N EVANGELICAL 1100 BAYER ROAD MATTITUCK,NY 11952 for : AS BUILT ELECTIC REWIRING OF THE KITCHEN IN SFD AS APPLIED FOR at premises located at County Ta~ Map No. 473889 Section 107 purs~t to application dated AUGUST Building Inspector to expire on FEBRUARY 1100 BAYER RD MATTITUCK Block 0009 Lot No. 030 7, 2009 and approved by the 12, 2011. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by JOHN LUDEMANN PO BOX 621 NEWSUFFOLK, NY 11956 ADVENT LUTHERAN CHURCH 1100 BAUER RD MATTITUCK, NY 11956 Located at Application Number: 4026570 Section: Block: Described as a Residential 1100 BAYER RD MATTITUCK, NY 11956 Lot: Certificate Number: 4026570 Building Permit:. BDC: ns11 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, kitchen, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the23rd Day of July, 2009. Name QTY Rate Rating Appliances and Accessories Dish Washer 1 0 1.2 Miscellaneous kitchen renovation Wiring And Devices Dimmer 5 0 120 V Fixture 11 0 Outlet 11 0 Outlet 13 0 Receptacle 2 0 Receptacle 9 0 Circuit* Tv~ Fixture Gen, Purpose GFCI Gen, Purpose 1 of I seal This cer[ificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. TOWN OF SOUTHOLD PROPERTY RECORD CARD ~, OWNER .STREET II 00 V,L~GE D,ST.SUB. 'O-~ FORMER O~/NER O~ 4h~ .~VeH'+ N '~ ' E R.,~ ,.., , s w ~ SEAS. VL. FARM COMM. CB. MISC. Mkt. Value ~~ '-,,. ~ND IMP. TOTAL DATE REMARKS ~/~ t ~ '7~lz " ' ' AGE BUILDING CONDITION N~ ~o~ ,~oW .~ov~ ~ , II FARM Acre Value Per Value Acre TiHoble 2 Tilloble 3 Woodlond Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot ._ DEPTH ~ ~ BULKH~D Totol DOC~, M. Bldg. 37 COLOR TRIM Foundation Bath Extension Basement Floors Extension Ext. Walls Interior Finish Extension Fire Place Type Roof Porch Recreation Room Porch Breezeway Garage Dormer Driveway Patio O.B. Total Heat Rooms 1st Floor Rooms 2nd Floor Dinette 'LR. DR. BR. FIN. B. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Approved ~ / [ Z- ,20 ~'f~ Disapproved a/c Expiration ~ ] ~"~ ,20 ] ~ PERMIT NO. ~:j4 ¢ff~3~ Z BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: ['~ [~ ~ ~ ~' Building Inspector ~ APPLICATION FOR BUILDING PERMIT -7 , ,, BraG. ~[~. INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plus, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and wate~ays. c. The work covered by this application may not be commenced before issu~ce of Building Pemit. d. Upon approval of this application, the Building ~spector will issue a Building Pe~it to the applicant. Such a pe~it shall be kept on the premises available for inspection t~oughout the work. e. No building shall be occupied or used in whole or in pa~ for any pu¢ose what so ever until the Building Inspector issues a Ce~ificate of Occupancy. f. Eveu building pe~it shall expire if the work authohzed has not commenced within 12 months a~er the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affbcting the prope~y have been enacted in the interim, the Building ~spector may authorize, in writing, the extension of the pe~it for an addition six months. Thereafter, a new pe~it shall be required. ~PLICATION IS HE,BY M~E to the Building Department for the issuance of a Building Pe~it pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordin~ces or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa~ inspections. ADVENT IIJI,IEI 8 OCCUPANCY OR 1100(~l~l~[l~cant or name, ifa corporation) r:'~ONS]'P,L;C ~10.,' SHALL .:',E HEOUFIEV, ENTSOFTH~bb IS UNLAWFUL .,d3 0F ~';: "" " '-'. "-, .STATE.WITHOUT CERTIFICATE (Mailing address ofapplioant) State whether applicant is owner, le~ ~~,G~ineer, general contractor, electrician, plumber or builder NoT-FoR- ProFO- o w ,v AP, PROVED AS I O 'ED _ Nameofo erofpremises,, *q¢^C Lo'4, u (/. / / (As on the tax roll or lates{~.3i ',, ,' .... ~ ?~' ~ ¢ If a~~~_ a~~ of duly authohzed officer FEE:~_ aV:_~ , or NOTIFY BUILDING BEZ&RTMENT AT (Name and title of co.orate officer) ~&~o¢ 7654802 8AM 70 4 PM FOR THE FOLLOWING INSPECTICNS: Builders LicenseNo. Plumbers License No. ElectficiansLicenseNo. Other Trade's License No. LINI)I:FIWSliI::H$ ~RTIFICATE Location of land on which proposed work will be done: House Number 'Street i.FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL. CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE i~F-~..UIB E_MF_~TS o ,F THE CODES OF NEW DlttfOi~eR CONSTRUCTION ERRORS. County Tax Map No. 1000 Section tO"/,O~ Block ~. O0 Lot 0_~. 000 Subdivision Filed Map No. Lot 2. State existing use and occupancy ofpremises,~ and intended use and occupancy of proposed construction: a. Existing use and occupancy !,)/~,~t 50 M ~,¢~, b. Intended use and occupancy. 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost 5. Ifdwelling, number of dwelling units If garage, number of cars Addition Other Work ~,~ Fee Alteration~ (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height. Number of Stories Dimensions of same structure with alterations or additions: Front , ......... R~a~ Depth Height_ Number of Stories~, ~ .,, 8. Dimensions o f entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO__ 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this properly within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. pERM!TS, ,MAy BE REQUIRED. 16. Provide survey, to scale, with accu~rate'fc~und~tion plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES__ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) SS: COUNTY OF ~o~U~ ) ~ eO 1/'9 (~ ~1~ J'l ~ ~ being duly sworn, deposes and says that (s)he is the applic~t (Namebf individual si~ing contract) above named, (S)He is the ~ O( (Contractor, Agent, Co.orate Officer, etc.) of said owner or owners, and is duly authorized to perfom or O~,~ffomed the said work and to make and file this application; that all statements contained in this application are tree to the best of his ~wledge and belief; and that the work will be pedb~ed in the ma~er set forth in the application filed therewith. /' Sworn m before me this ~ [ / ~ / / Nota~ Public ' 0ualifi_~ :~. 30-47~1154 .... summers@optonline.net August 04, 2009 Southold Town Building Department Box 1179 Southold, NY 11971-0959 C~eor~ge ,~ummcrs, ~'astor TOW~ OF SOU TO WHOM IT MAY CONCERNED: We are in receipt of the enclosed letter. There has been no construction done to our church at 200 Legion Ave. (1000-1' 23). When ! spoke to your office, you indicated receiving a certificate for an electrical inspection. !f that is the constructi_~Nou-a~e referring to, it is for our parsonage at 1100 Bayer Rd ~~-.03)~. n r, lattituck. We recently had our kitchen rewired becauSe-of Sa~J:Zy~oncel'l~tr~_ ~ The person ! spoke to on the phone sent the enclosed form, which 1 have return filled out. We have not yet received anything regarding the electrical inspection, but you have. You may need to attach that to our application. We were certainly not aware that such a minor interior job required a building permit in Southold Town, and we object to the need for any fee whatsoever since we have already paid for the electrical underwriters inspection, and are a tax exempt not-for-profit organization. George Summers Pastor 1 I O0 [~)a..qer Ma i uck, New york I Letterhead Iogos.wps 8/4/2009 BAYER ROAD ~1 75° 5')' 5.')" F I 4,50 0¸5' STORY RESIDENCE 606 ' EIO' 0~' L 0 T -50 38.5' LOT 49 ? 75~ 5n' 50"W 85 50' LOT 78 CM FOUND FM No 1184 SURVEY OF SURVEYED 17 DECEMBER 1988 ~LED 'J'J~-Y 24, 1935 LOTS '49 8~ 50 ~c,~ ,":3o' TM I000-107-9-~ in .AMENDED MAP OF MATTITUCK HEIGHTS SI TUA TE MATTITUCK, TOWN OF SOUTHOLD, SUFFOLK CO, N.Y SURVEYED FOR ADVENT LUTHERAN CHURCH GUARANTEED TO ADVENT LUTHERAN CHURCH NORTH FORK BANK ,~, TRUST CO. SECURITY TITLE ~ GUARANTEE CO TOWN OF SOUTHOLD Guarantees Indicated hem ee ~ only to the petit fer vRtom file is prepared, and ~ hi~ bel~aff to title ccmpany, Goverme~tal Agency, lending institution, if listed hereon, and to the cssignees of the lending Institution. Guarantees are not transferable to additional instituti0,~$ ar s~bsequent owner~. SURVEYED BY STANLEY J. ISAKSEN, ,JR P O, BOX 294 A',C,. N ,L / .S_.SURVEYOR I f N. YS L~c.//Nol 49~7~ ~ Copies of ~s s~ m~P ~t bee~g not be ~red ~ be a valid tm ~y. [~uauthorized alterat~n or addillua to Ibis s' rvey is a violatiea of Sectic~ 7209 of the New Yo~ Slate Education Law. 88R 405